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Estimating the global cost of vision impairment and its major causes: protocol for a systematic review
  1. Ana Patricia Marques1,
  2. Jacqueline Ramke1,2,
  3. John Cairns3,
  4. Thomas Butt4,
  5. Justine H Zhang1,
  6. Hannah B Faal5,
  7. Hugh Taylor6,
  8. Iain Jones7,
  9. Nathan Congdon8,9,
  10. Andrew Bastawrous1,
  11. Tasanee Braithwaite1,10,
  12. Marty Jovic11,
  13. Serge Resnikoff12,
  14. Allyala Nandakumar13,
  15. Peng Tee Khaw14,
  16. Rupert R A Bourne15,
  17. Iris Gordon1,
  18. Kevin Frick16,
  19. Matthew J Burton1,10
  1. 1International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
  2. 2School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
  3. 3Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
  4. 4UCL Institute of Ophthalmology, University College London, London, UK
  5. 5Department of Ophthalmology, University of Calabar, Calabar, Nigeria
  6. 6University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
  7. 7Sightsavers, Haywards Heath, UK
  8. 8Centre for Public Health, Queen’s University, Belfast, UK
  9. 9Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, Guangdong, China
  10. 10Moorfields Eye Hospital, London, UK
  11. 11PricewaterhouseCoopers, Sydney, New South Wales, Australia
  12. 12Brien Holden Vision Institute, University of New South Wales, Sydney, New South Wales, Australia
  13. 13Brandeis University Heller School for Social Policy and Management, Waltham, Massachusetts, USA
  14. 14NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
  15. 15Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK
  16. 16Johns Hopkins University Carey Business School - Baltimore Campus, Baltimore, Maryland, USA
  1. Correspondence to Ana Patricia Marques; Patricia.Marques{at}


Introduction Vision impairment (VI) places a burden on individuals, health systems and society in general. In order to support the case for investing in eye health services, an updated cost of illness study that measures the global impact of VI is necessary. To perform such a study, a systematic review of the literature is needed. Here we outline the protocol for a systematic review to describe and summarise the costs associated with VI and its major causes.

Methods and analysis We will systematically search in Medline (Ovid) and the Centre for Reviews and Dissemination database which includes the National Health Service Economics Evaluation Database. No language or geographical restriction will be applied. Additional literature will be identified by reviewing the references in the included studies and by contacting field experts. Grey literature will be considered. The review will include any study published from 1 January 2000 to November 2019 that provides information about costs of illness, burden of disease and/or loss of well-being in participants with VI due to an unspecified cause or due to one of the seven leading causes globally.

Two reviewers will independently screen studies and extract relevant data from included studies. Methodological quality of economic studies will be assessed based on the British Medical Journal checklist for economic submissions adapted to costs of illness studies. This protocol has been prepared following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols and has been published prospectively in Open Science Framework.

Ethics and dissemination Formal ethical approval is not required, as primary data will not be collected in this review. The findings of this study will be disseminated through peer-reviewed publications, stakeholder meetings and inclusion in the ongoing Lancet Global Health Commission on Global Eye Health.

Registration details (DOI 10.17605/OSF.IO/6F8VM).

  • ophthalmology
  • public health
  • health economics

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  • Contributors APM, JC, JR and MJB conceived the idea for the review. APM, JR and ThB drafted and revised the protocol with suggestions from MJB, JC, JHZ, HBF, HT, IJ, NC, AB, TaB, MJ, SR, RRAB, AN, PTK and KF. IG constructed the search.

  • Funding MJB is supported by the Wellcome Trust (207472/Z/17/Z). JR is a Commonwealth Rutherford Fellow funded by the UK government through the Commonwealth Scholarship Commission in the UK. The Lancet Global Health Commission on Global Eye Health is supported by The Queen Elizabeth Diamond Jubilee Trust, Moorfields Eye Charity [grant number GR001061], NIHR Moorfields Biomedical Research Centre, The Wellcome Trust, Sightsavers International, The Fred Hollows Foundation, The SEVA Foundation, The British Council for the Prevention of Blindness and Christian Blind Mission.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.